Provider Demographics
NPI:1699426387
Name:DOWELL, KAYLA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KAYLA
Middle Name:
Last Name:DOWELL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 TRINITY LN
Mailing Address - Street 2:
Mailing Address - City:POPLAR BLUFF
Mailing Address - State:MO
Mailing Address - Zip Code:63901-6893
Mailing Address - Country:US
Mailing Address - Phone:618-789-7677
Mailing Address - Fax:
Practice Address - Street 1:3001 OAK GROVE RD
Practice Address - Street 2:
Practice Address - City:POPLAR BLUFF
Practice Address - State:MO
Practice Address - Zip Code:63901-8942
Practice Address - Country:US
Practice Address - Phone:573-772-7164
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-13
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051304459183500000X
MO2021027200183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist